Prognosis of adult patients transplanted with liver grafts < 35% of their standard liver volume

✍ Scribed by Toshihiko Ikegami; Yuichi Masuda; Yasunari Ohno; Atsushi Mita; Akira Kobayashi; Koichi Urata; Yuichi Nakazawa; Shirou Miwa; Yasuhiko Hashikura; Shinichi Miyagawa

• Publisher: John Wiley and Sons
• Year: 2009
• Tongue: English
• Weight: 185 KB
• Volume: 15
• Category: Article
• ISSN: 1527-6465
• DOI: 10.1002/lt.21716

✦ Synopsis

We have previously reported that a graft volume (GV) Ͼ 30% of the recipient's standard liver volume (SLV) can meet the recipient's metabolic demands. Here we report our experience with adult-to-adult living donor liver transplantation using left side grafts Ͻ 35% of the recipient's SLV. Of 143 adult living donor liver transplants, 13 auxiliary partial orthotopic liver transplants, 8 right side grafts, and 2 retransplantation cases were excluded. The resulting 120 cases were divided into 2 groups: group S consisted of 33 patients who received liver grafts Ͻ 35% of their SLV, and group L consisted of 87 patients who received liver grafts Ն 35% of their SLV. Patient characteristics, postoperative liver function, duration of hospital stay, and recipient survival rates were compared between the 2 groups. There were no significant differences between groups in recipient or donor background characteristics. The mean GV/SLV ratio of group S was 31.8%, whereas that of group L was 42.5%. There were no significant differences in the postoperative serum total bilirubin levels, prothrombin time international normalized ratio, daily ascites volume, or duration of postoperative hospital stay between the groups. The 1-and 5-year survival rates in group S were 80.7% and 64.2%, respectively, whereas those of group L were 90.8% and 84.9%, respectively, with no significant difference between groups. In conclusion, graft size was not considered to be the only cause of so-called small-for-size graft syndrome, and left side grafting appears to be the procedure of choice for adult-to-adult living donor liver transplantation because of the lower risk to donors in comparison with right lobe grafting.